- ability to develop data requirements and work with compilance analyst and other analytical groups to extract, organize and analyze coded data.patient, patient account,
- ability to work with and maintain confidentiality of physician, and personnel data.
- monitor corrective actions for auidt review findings.
- must be available to work flexible days and hours.
- demonstrated ability to work independently with minimal supervision, including willingness to be flexible depending upon department and/or physician schedule needs.
- monitor coidng performance to enusre lasting improvement.
- demonstrated ability to review analytical, data and audit findings to identify coidng trends and risk areas.
- must be able to work in a labor/management partnership environment. this position is expected to become an active participant in loacl and regoinal continuous quailty improvement processes and workgroups, with a strong partnership with the compilance analyst , data quality specialists and other medcial cetner analytical groups.the compilance audtior is also resposnible for synthesizing loacl and regoinal audit findings to provide actionable feedback to local administrators and physciians on areas for improvement - this position is expected to use independent judgment and sensitivity when educating physicians on appropriate coidng and medical documentation. this position is also expected to identify other review methods to assess coding quality (than traditional coding audits and review) than result in faster feedback to local opertaions stfaf and physicians. verbal and presentation skills to share audit findings, risk areas and compliance isuses, coding and bililng requirements
- demonstrated ability to effectively work within a team environment,
- audit skills and the ability to interpret and apply fedreal and sttae regulations, using excellent written.certified coding specialist (ccs), certified professional coder (cpc), e. registered health information administrator (rhia), and 3 or more years coding experience.
- using independent judgment and sensitivity, review with individual physicians their audit findings and make suggestions for coding improvements.
- certification in one of the following: i.
- actively participate in local ecs oversight committee and ecs champion physicians to work to resolve local coding issues, ensure compliance with local and regional audit plan and act as communciation link regadring chagnes to federal and state govenrment billing and coding guidleines.compliance audtior-coding-west los anglees
loctaion: los anglees, ca
the compliance auditor is responsible for partenring with local and regional medical center physicians and operations staff to ovesree the quality and accuracy of outpatient coded clinical and administrative data, and to work with regional compliance to develop and implement an scal compliance plan that meets federal and other regulatory standards.
- assists in developing and implementing policies and procedures/compliance audit standards to ensure compliance with federal, state and other regulatory requirements.
- identify through focused audits operational and regulatory issues related to coding, and compliance reguirements, ensuring that appropriate documentation is maintained to comply with federal and state requirements, documentation.dqss and other local analytical workgroups to identify audit trends and risk areas based on audit findings and data analysis - formulate recommendations for future training and areas of education and focus based on findings,
- partner with compliance analyst.
- conduct confidential audits for specific providers who represent a risk due to special circumstances or prior audit issues - work with medical center leadership to provide confidential feedback on an \'as needed\' basis.
- strong interpersonal and excellent written and oral communication skills.nursing or other ancillary medical area, medical records technology, health services administration,
- bachelor\'s degree or equivalent experience in finance/business.
- prepare and/or perform regional and medical center auditing analysis and/or special projects as assigned.state and local regulations, adherence to federal,
- assure compliance of operational processes and outpatient encounter data capture throughout southern california kaiser permanente making determinations with respect to appropriateness of documentation.
- partners with ecs dqs\'s to review regional and local audit findings to identify coding risk areas, and ensure that medical center training activities are addressing these areas.
- travel between all medical center facilities may be required.
- demonstrated ability to constructively and sensitively provide feedback to physicians and medical center leadership regarding federal and state coding, medical documentation and compliance guidelines, audit results and risk areas.